Case

A patient was in a side car impact where the drivers side door collapsed inward impacting the anterolateral aspect of the patients left torso. The patient indicates they have extreme pain when moving their left arm and shortness of breath. The pain is significantly stronger than during quiet breathing. When moving the arm back and forth you hear a 'clicking' - Click here for sound  - A CT is also ordered and shows

Question 2/3 - What do you think is making that noise?

Click on your selected option(s) below  (correct = 1, over-thinking = 2+)

Next Question

Incorrect. While joints can 'pop', due to movement and cavitation of the synovial fluids, this is usually caused by rapid movement of the joint which a patient in pain is unlikely to do. Also, this effect is typically only present in small joints such as the knuckles.

Correct! The clicking noises (called crepitus) are common noises that occur when broken bone ends rub against each other.

Incorrect. While soft tissue and rib damage may disturb breathing, that is unlikely to cause significant alteration to breath sounds from the lung. However, if lungs are injured as well then fluid in the space will distort breath sounds (muffling or eliminating breath sounds).

Incorrect. Muscle spasms do not cause any discernable sound.

Incorrect. While involuntary vocalizations with pain are to be expected, the nature and frequency of the sounds are inconsistent with exclamations of pain or gasps that a patient may be expected to make.